Why You Aren’t Getting A Period With Low Dose Birth Control

If you are taking low dose or very low dose birth control (which includes the vast majority of women who take birth control pills) you are likely not going to get a period or your period is going to be very light. When I use the word “period” here, I really mean a withdrawal bleed as this is not a real period (more on this in another post). Also I am referring to combination birth control pills here, which include estrogen and progestin.

It’s surprising to me that so many women do not know that it is normal to not get a period or to have a very light period with low dose birth control. Understanding that it is normal to not get a period with low dose birth control should be one of the very first things that is made understood. 

First, it is important to understand what birth control pills are doing…

The reason why you likely will not get a withdrawal bleed when you take very low dose birth control is best understood if you understand what birth control is doing in the first place:

  1. When you are taking estrogen and progestin (the hormones in combination birth control) their presence and constant level shuts off ovulation (ovulation is when a follicle in one of your ovaries releases an egg).
  2. The estrogen component works to increase the lining of the uterus (the lining of the uterus is called the endometrium) and to maintain the integrity of this lining. 
  3. When you stop taking these hormones during the fourth week of the pill pack, this causes a drop in your progesterone and estrogen. This means the lining is no longer being stimulated by the estrogen, and the dip in progesterone also acts as a signal for the body that pregnancy has not occurred and the lining can be shed (because if pregnant you’d want this lining thick for the egg to implant and fertilize).

So now back to low dose birth control…

Low dose birth control means you are taking very low doses of estrogen and progestin at a constant level. The very low dose of estrogen builds up the lining of the uterus only very slightly, which is why when stop taking the hormones the last week of the pill pack, that week you get a very slight noticeable bleed or you don’t even notice the shedding because it is so light.

Main take aways…

Low dose birth control is by far the most common form of birth control prescribed, and it is important that you understand that you may not get a withdrawal bleed and that is totally healthy and normal. If you are having sex regularly and you are nervous about not getting a period, you can still take low dose birth control but you can take the higher end of the low dose variety.

About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California with an expertise in women’s health and preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab

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